This study reports on a skills-enhancement training series for direct care workers providing personal assistance under a waiver for Medicaid home care services. Designed to increase professionalism, the training was part of a federally funded state-level initiative to promote change in the community-based long-term-care system. A linear improvement in the ratings of training quality was documented, with the module on stress management rated most highly. The modules pertaining to issues of bereavement and stress management were judged to have more impact than those related to effective communication and dealing with the challenging needs of clients. In general, participants placed greater value on content that contributed to their personal and professional empowerment. Results are discussed as they relate to the social undervaluation of care work, and it is suggested that quality care can be elevated and redefined to reflect the moral bonds underlying professional relationships between caregivers and care recipients. © 2008 Sage Publications.